微创胫骨远端L型锁定钢板治疗Pilon骨折16例临床分析

Clinical Analysis of 16 Cases of Pilon Fracture Treated with Distal Tibia L Locking Plate of Minimally Invasive

目的：探讨采用微创胫骨远端L型锁定钢板治疗Pilon骨折的手术要点与临床治疗效果。方法：回顾分析笔者所在医院2013年1月-2014年6月16例Pilon骨折患者的资料,采用胫骨远端前侧微创有限切开复位L型锁定钢板内固定。其中合并腓骨下段或外踝骨折则作后外侧纵切口11例,复位后根据骨折情况决定选用1/3管形或重建钢板固定或腓骨远端外侧钢板固定。结果：术后随访6~18个月,所有患者均达到临床愈合。无内固定松动、断裂、骨折移位、皮瓣坏死、切口感染等并发症发生。采用Johner-wruhs评分系统评估手术疗效,优10例,良4例,中2例,差0例。无切口感染发生。结论：微创胫骨远端L型锁定钢板治疗Pilon骨折,具有手术创伤小,骨膜剥离明显减少,从而有效保护骨折处血供,明显提高骨折的治愈率,降低骨折并发症的发生。同时患者在临床上可进行早期的踝部功能锻炼,故可获得满意临床疗效。

Objective： To disscuss the operation main points and clinical therapeutic effect of Pilon fracture treated with distal tibia L locking plate of minimally invasive.nethod： The data of 16 cases of Pilan fracture patients treated with distal tibia minimally invasive limited open reduction of side L locking plate internal fixation were retrospectively analyzed in our hospital from January 2013 to June 2014.11 cases of fibula segment or external ankle fractures were performed after the lateral and longitudinal incision, the decision to choose reset 1/3 tubular or reconstruction plate fixation or fibula distal lateral plate fixation according to the fracture situation.Result： 6-18 months follow-up after operation, all fracture patients were reached clinical healing. No internal fixation loosening or fracture, fracture displacement, skin flap necrosis, infection of incision, complications, etc.The Johner-wrnhs grading system was used to evaluate surgical curative effect, 10 cases were good, 4 cases were well, 2 cases were medium, 0 case was poor, no incision infection.Conclusion： Distal tibia L minimally invasive locking plate for Pilon fractures is with a small surgical trauma, periosteal stripping significantly reduced, thus protect fracture blood supply effectively, improve the cure rate of fracture and reduce the fracture complications.At the same time, patients in clinic are able to take early ankle function exercises, it can obtain satisfactory clinical effect.